Capacity and Consent

Question 1

What is considered valid consent?

Answer 1

• Consent given freely without coercion
• Legally capable of consenting
• Cover the intervention/procedure
• Informed

Question 2

If you are consenting a patient to treatment, what must you remember to tell the patient?

Answer 2

• What the treatment consists of
• The main beneficial effects
• Risks and unwanted side effects
• Consequences of not receiving treatment

Question 3

If patients struggle to understand or communicate their decision but you are thinking that they have capacity to consent, what aids can you offer to help them make their decision?

Answer 3

• Written/visual aids
• Translators
• Friends/relatives
• Time to reflect

Question 4

A person may have capacity for one decision but not another. TRUE/FALSE?

Answer 4

TRUE

Question 5

What 3 criteria must a patient meet to be deemed that they have capacity?

Answer 5

1) Understand and retain relevant information
2) Use and weigh that information to make a decision
3) Communicate that decision

Question 6

Capacity should be assumed until proven otherwise. TRUE/FALSE?

Answer 6

TRUE

Question 7

If in an emergency you did not have time to fill out the legal paperwork, but required to treat a patient, what would you do?

Answer 7

In a medical emergency, deal with the situation then deal with the legal paperwork

Question 8

What are the aims of the Adults With Incapacity Act (AWI)?

Answer 8

1) Intervention must benefit the adult
2) Such benefit cannot reasonably be achieved without the intervention
3) Take account of past and present wishes
4) Consult with other relevant persons
5) Encourage the adult to use residual capacity

Question 9

What section of the adults with incapacity act provides the certificate to authorise a patient as lacking in capacity?

Answer 9

Section 47 Certificate of Incapacity

Question 10

What does a Section 47 certificate under the AWI authorise and NOT authorise?

Answer 10

• practitioner can provide interventions related to the treatment authorised
• Does NOT authorise force unless immediately necessary and only for as long as is necessary
• Does NOT authorise the transport of the adult to the place of treatment

Question 11

What is documented on a Section 47 AWI form?

Answer 11

• your details
• patient details
• treatment you want to authorise
• nature of incapacity and how long you expect it to continue
• sign and date it

Question 12

What is a patient’s Power of Attorney?

Answer 12

• One or more people granted with the power to act as patients financial/welfare decision maker
• Granted whilst patient has capacity in case this is lost in future

Question 13

What is Guardianship of a patient?

Answer 13

• Granted by the sheriff
• Welfare and/or financial
• Person requires someone to make specific decisions on their behalf over the long term

Question 14

At what age does legislation say that young people are deemed to have the capacity to consent?

Answer 14

16 years

Question 15

What should be done if a child does NOT have capacity to make a decision?

Answer 15

• If a young person lacks capacity, ask ONE parent for consent (both parents can discuss)
• If parents disagree – seek legal advice

Question 16

When should the Mental Health Act be used OVER parental consent?

Answer 16

In situations such as:

• Use of force
• Use of intramuscular medication
• Certain treatments e.g. nasogastric feeding, ECT
• Detrimental impact on relationship with carer